Care Management Clinician Team Lead

PacificSource Health Plans•WFH: MT, MT

8d•$83,212 - $137,300

About The Position

The Care Management Clinician Team Lead is accountable for effectively managing Clinical Care Managers for assigned lines of business. The role oversees hiring, training, coaching, counseling, performance evaluation, team workflow, quality, and productivity. The Team Lead may also perform routine program functions and participates in program development, implementation, maintenance, process improvement, and issue resolution. The position provides guidance on company policies, procedures, and operations and supports the overall effectiveness of the Health Services team. The role coordinates with PacificSource departments and community partners, serves on designated committees, promotes evidence-based tools, maintains a modified caseload, and helps ensure exceptional service to members, providers, employers, agents, and other customers. It also provides backup to other teams or management staff as needed. The work is performed inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. The listed base salary range is $83,212.29–$137,300.29; actual compensation depends on qualifications, experience, education, and internal equity.

Requirements

At least five years of clinical experience, including case management experience.
Active, unrestricted RN license, LPC, LMFT, or LCSW credential.
Certified Case Manager (CCM) certification accredited by CCMC, required at hire or within two years of hire.
Knowledge of health insurance and state-mandated benefits.
Thorough knowledge and experience in case management practice, including advocacy, assessment, planning, communication, education, resource management, and service facilitation.
Effective adult education or teaching and group leadership skills.
Ability to work effectively with people who have various health issues and concerns.
Strong analytical and organizational skills, including experience with information systems and computer applications.
Flexibility and ability to develop, review, and evaluate utilization and case management reports.
Strong computer skills, including Word, Excel, and PowerPoint.
Ability to use audio-visual equipment.
Ability to work independently with minimal supervision.
Skills in accountable leadership, collaboration, written and verbal communication, critical thinking, decision making, influencing, active listening, and planning and organization.
Ability to stoop and bend; sit and/or stand for extended periods; perform repetitive motions such as typing, sorting, and filing; and lift and carry files and business materials weighing a light amount.
Ability to read and comprehend written and spoken English and communicate clearly and effectively.

Nice To Haves

At least three years of direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management.
Prior supervisory experience.

Responsibilities

Lead development, implementation, operation, and maintenance of assigned programs, services, or functions.
Oversee and coach team members; manage team performance and improve processes and outcomes.
Monitor daily workflow, caseloads, and work processes to ensure appropriate distribution and processing of tasks.
Orient and train new hires; provide ongoing supervision, training, evaluation, and leadership to assigned team members.
Participate in hiring decisions with the Director and/or Health Services Manager and Human Resources.
Monitor and take action on team assignments related to volume, timeliness, accuracy, customer service, and quality and performance measures.
Support process improvement across departments, use lean methodologies, and use visual boards to monitor key performance indicators and identify opportunities.
Serve as a liaison with other departments and community partners, serve on designated committees, and communicate pertinent information to the team or department.
Utilize and promote evidence-based tools.
Maintain a modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues and conflict resolution as needed.
Oversee and assist in providing service and information to members, providers, employers, agents, and other internal and external customers.
Model effective written and verbal communication.
Provide backup to other departmental teams or management staff as needed.
Meet department and company performance and attendance expectations.
Communicate new or revised policies, procedures, and processes to team members.
Facilitate team operations by sharing information, identifying teamwork issues, developing problem-solving recommendations, and recommending standardized Health Services operations.
Represent the Health Services Department internally and externally as requested by the Health Services Manager and/or Director.
Perform other duties as assigned.